Essay Sample on Adequate Nutrition and Micronutrients for Normal and Pathological Pregnancy

Introduction

In normal and pathological pregnancy, the mother is required to provide adequate nutrition to the growing fetus. The micronutrients are therefore cofactors for themselves or can act an antioxidant in both normal and pathological pregnancy (22). Oxidative stress is normal during normal pregnancy when the placenta development but when antioxidant micronutrients are in short supply, the placenta and maternal circulation experiences exaggerated oxidative stress (12, 17, 14, 22). To avoid the buildup of oxidative stress during normal pregnancy micronutrients antioxidants such as selenium copper, zinc, manganese as well as vitamin C and vitamin E should be inadequate supply (1, 3, 22). For example, the antioxidant activities of most micronutrient are through the incorporation of the same into the glutathione peroxidase enzymes (9, 11).

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Lack of adequate selenium can lead to miscarriage and in most cases preeclampsia (5) Manganese is important in maintaining fetal growth and can be supplied to prevent restricted fetal growth (22). Manganese is also an important cofactor for manganese superoxide dismutase which is the antioxidant that protects the placenta from the oxidative stress as it detoxifies superoxide anions (2). On the other hand, copper and zinc are important micronutrient cofactors responsible for Superoxide dismutase (SOD) which is required in the catalysis of the dismutation of superoxide radicals (O2) form the molecular oxygen and hydrogen peroxide (H2O2) (22). Oxygen and hydrogen peroxides are the element and compound that provides the necessary cellular defense against the reactive oxygen species during pathological pregnancy (20, 22). Copper is an important cofactor in metabolic reaction and embryonic development with maternal copper deficiency leading to early embryonic death and gross structural abnormalities (14, 18). Cu/Zn superoxide dismutase is expressed in maternal and fetal tissues especially in the plasma and umbilical cord plasma because the placenta blocks the maternal-fetal copper transfer (12). Copper contributes to developing fetal weight that is why copper supplementation in pathological pregnancy is advice.

Vitamin C can satiate several reactive nitrogens but is administered in low doses for pregnancy (<200 mg/day) but in high doses as a supplement (between 500-1000 mg/day) in combination with vitamin E (4, 9, 10). Smoking during pregnancy can signally reduce vitamin C availability and increase oxidative stress that is why pregnant women should take at least 235 mg/day of Vitamin C (21). On the other hand, vitamin E is a chain breaking anti-oxidant that can prevent the propagation of lipid peroxidation (16).

Zinc plays a major role as micronutrient supplementation in most pregnancy disorders. It is a constituent more than 100 enzymes used in the synthesis of proteins and other antioxidants. Zinc plays an essential role in embryogenesis as it helps in fetal brain development and aids the mother during labor (7, 6). Pregnant women require higher doses of zinc in their third trimester that is why the plasma zinc concentration can significantly reduce by the third trimester (8). Lack of zinc during pregnancy can lead to prolonged labor, and poor fetal growth (15). Women are given zinc supplementation during pregnancy report higher birth weights and, in most cases, some women reported larger head circumferences (15). Therefore, to avoid oxidative stress, zinc supplementation is needed without which pregnancy-induced hypertension is likely. Additionally, most cases of preeclampsia have been associated with zinc deficiency (13). Low serum zinc concentration affects both antioxidant protection and contributes to high blood pressure that is why oxygen and zinc-binding protein levels should be maintained during pregnancy.

References

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